Have you communicated with your husband on where you are at? Don't share as a threat, but he needs to know how serious things are. He should have a chance to become aware, so he can makes changes, and so he's not taken by surprise when/if you break.

Pray before sharing. Pray that the Spirit will prepare your husband's heart and that he's convicted, where he needs to be convicted. And, pray for yourself, that you communicate in love and say only what the Lord wants you to say. Pray that you both will have ears to hear, and eyes to see, and that the Lord will do more than you can imagine and draw you two closer through this.

Getting him healthy and his T normal won't change his heart, only God can do that, but it will help his motivation with changing.

Praying for you.

God can change what people do, behavioral patterns that have been in play for decades. He can change what we do to cope, find comfort, survive conflict, to count. Rahab had done a same old thing for years...then she did something new.

If you've been married 25 or 30 years to a great guy and you see a huge change after some medical trauma, understand that this definitely falls under the "for better or worse, in sickness and in health" part of your vows. That does not mean that you don't need to seek help--you do. But your husband isn't the enemy here; his medical condition is causing side effects neither of you would choose. If you knew that it was Alzheimer's or a brain tumor, you'd say "Ah, it's physical--we can find ways to manage the symptoms as well as possible, but this is a time we need to learn a new normal, and I need to love him through it even if it's hard." The circumstances are different, but the medical reality the same. This is the time your husband needs you, even if he isn't "giving" much back at the moment. Most marriages have such periods--I'm quite a lot older than my marriage date would indicate, and I've seen several marriages within my family go through marital challenges including, in several cases, death. This is the time that you learn to lean on Christ, not your husband, as you choose to love your husband well even when it is difficult. I don't say that lightly, but with some knowledge of how difficult it is. (I've held a sobbing grown man through serious health challenges in his life mate, and a member of my extended family is currently battling Alzheimer's after a couple other ones died of it.)

You need rest and a break, a break such as going out to lunch with a friend, but not the type of break implied in ending a multi-decade marriage because of health challenges, even hard ones.

While caring for my chronically-ill wife, I found that some time to get out and do things myself was paramount for me. I hired a caregiver, she was not a nurse, but she could help with the basics, and I could leave and pursue my own activities. It helped me to overcome my weariness and I think I was a better husband with some "balance" restored.

I think the serious medical issues are on the mend and now the OP is lonely and dejected by a DH with Low T and LD. If he has recovered enough to engage in sex but does not THAT is a refusing spouse.

Being intimate does not even always require PIV as he can be generous with you in other ways if PIV is too taxing. Medical issues are relevant in the marriage bed but are not necessarily an excuse to not fulfill your duties as a spouse.

It sounds like he is focused on his issues and not seeing/caring about your pain. This is really a "us" issue and he needs to see that. If he had a MI it isn't unusual for men to suddenly have an emotional side show itself that was not previously seen. You're in my prayers.